1. Field of the Invention
The present invention relates to surgical devices capable of performing both argon plasma coagulation and traditional electrocautery during loop electro-surgical excision and other procedures.
2. Brief Description of the Related Art
A loop electro-surgical excision procedure, known as LEEP, is a procedure performed to treat cervical dysplasia, which is an abnormal tissue growth in the cervix. This procedure also is known as a Large Loop Excision of the Transformation Zone, which often is abbreviated as LLETZ or LEETZ. In the LEEP procedure, a wire loop is used to remove the abnormal tissue from the cervix. The wire loop is connected to an electrosurgical unit and is used to scoop out the abnormal tissue in one piece and seal any bleeding blood vessel via electrocautery. The procedure allows the healthcare provider to locate and remove the cervical dysplasia in one procedure, thereby saving the step of taking a sample piece of tissue (a biopsy) before removing the tissue by other methods, such as by freezing it or by performing a surgical cone procedure.
A variety of LLETZ devices are known and have been used for these procedures. These known devices typically have an elongated body with a pair of arms extending perpendicular to the body at one end. A wire electrode extends outward from each of the arms thereby forming a wire loop at the end of the device. The body further has means for connecting the wire loop to an electrosurgical generator. The arms can be of a variety of lengths and sizes. Examples of such conventional LLETZ electrodes are Valleylab's single use LLETZ electrodes catalog nos. E1559, E1560, E1561, E1562, E1565, E1566 and E1567. In these Valleylab devices, the arms are fixed in positions approximately perpendicular to the device body to thereby create or support the sire loop. In other known LLETZ devices, the arms are fixed in positions other than perpendicular to the body. Other embodiments of LLETZ devices are disclosed in U.S. Pat. Nos. 5,318,448 and 5,554,159, which are hereby incorporated by reference in their entirety.
Another embodiment of a known LLETZ device is disclosed in U.S. Pat. No. 6,416,513 to Dresden, which is hereby incorporated by reference in its entirety. In this embodiment, the device has a moveable arm that may be adjusted by the surgeon to adjust the concavity of the wire loop electrode.
One of the risks of the LLETZ procedure is heavy bleeding. Heretofore, a variety of means have been used to control such heavy bleeding. For example, traditional electrocautery may be performed using the wire loop electrode in the device or a paste may be applied to the tissue to reduce bleeding. Other known means of controlling bleeding have likewise been used.
Controlling or arresting blood loss is of high priority during surgery so as to avoid or minimize the necessity of introducing foreign blood or blood products into a patient. This has increased in importance due to concern over contamination of the blood supply by viral agents which cause, for example, acquired immune deficiency syndrome (AIDS), hepatitis, and the like.
Standard means for controlling traumatic and surgical blood loss are electrosurgical generators and lasers, which respectively direct high-frequency electrical currents or light energy to localize heat in bleeding vessels so as to coagulate the overlying blood and vessel walls.
Argon beam coagulators, also known as Argon Plasma Coagulators (APC), additionally have been demonstrated to be effective tissue coagulators. Examples of argon beam coagulators for use in open surgery can be found in U.S. Pat. No. 4,040,426 to Morrison and U.S. Pat. No. 4,781,175 to McGreevy. Argon beam coagulators for use rigid and flexible endoscopy also are known. An example of a device for flexible endoscopy may be seen in U.S. Pat. No. 5,207,675 to the present inventor. In some embodiments in that patent, the inventor disclosed dual modality devices that could be used either for argon plasma coagulation or for traditionally electrocautery in an endoscopic environment. The inventor also disclosed an embodiment having the dual modality of argon plasma coagulation and endoscopic biopsy forceps. In that embodiment, argon plasma coagulation could be used by a surgeon while the biopsy forceps were withdrawn inside the flexible endoscopic tube. The biopsy forceps could then be extended and used, but argon plasma coagulation was not performed with the biopsy forceps extended from the end of the tube.
With respect to LLETZ procedures, the conventional LLETZ device may be removed from the patient and an argon beam coagulator may be inserted to control bleeding.
While these known LLETZ devices and various means of controlling bleeding have been used in the past with varying degrees of success, a need exists for a single device that can perform a traditional LLETZ procedure and use argon beam coagulation to quickly control bleeding without repeated insertion and removal of instruments.